What are some important and memorable causes of dental trauma?

Doctor's Answers 3

Well, this is an interesting question. The most memorable case of dental trauma that I’ve seen in my career involves a patient who was a victim of domestic violence. This lady was severely beaten up by her then-husband, who used a baseball bat at home and swung it at her face when they got into a huge fight.

The ex-husband actually carried her and threw her off the balcony of their condominium. So she plummeted three storeys down but she survived. She did not die. She fell down three storeys, was thrown off the balcony, so it was, of course, a police case. I had to give a statement as well to the police, the investigating officer. And I think the ex-husband should be in jail by now.

She sustained heavy injuries all over her body and to her face and teeth. By the time she came to me, she had already gone through multiple surgeries to fix her broken ribs and her broken bones and major issues. So now it’s down to fixing her teeth. She could not face the world because her teeth were all broken and she couldn’t smile, and she was in pain constantly. So she gave me a picture of herself before the incident, she showed me a picture of herself smiling. I sat down with her and I told her that we could really try to reconstruct her teeth to make her look like what she did before.

So with smile design, implants, crowns and veneers, we managed to completely reconstruct her smile. So she looked very close, almost the same as what she did before and it was such a touching moment. She was very grateful and she burst out in tears.

It was quite an emotional moment for me and I would never forget that a person’s sense of self-worth is so attached to their teeth and to their smile. So dental trauma is a topic that I’m really passionate about.

Any kind of patient who has suffered an injury or traumatic injury to the mouth or to the teeth, we are really privileged as dentists to be able to help. To reconstruct the teeth not just to be able to move, for the patient to bite, but so that they can have that sense of self-worth and confidence to smile, to go into social settings. To not be embarrassed to be in a social setting and be recluse and hiding at home.

Most cases that I see, Dr Gerald has seen as well because in our clinic we do a multi-disciplinary approach. Dr Gerald is very strong in surgery but some patients like the little girl who’s just 10 years old -- we’re not going to put dental implants in her. But for some patients with trauma, a lot of them tend to end up with root canal complications.

For adult patients, usually, the nerve is not going to heal itself, so we have to do the conventional root canal treatment. For children, there’s a greater chance that you can have a recovery of the nerve, which is important for the growth and development of the root. Because if the root is very thin, then in future even if all the teeth are there you may end up with a root fracture.

So for that case what we actually tried to do was to allow the root to heal in a process called a pulpotomy. We removed part of the root canal tissues, you don’t remove all like you would in a root canal. That’s something quite interesting. So far it’s healing well but in these cases, you need long-term follow-up. Long-term meaning years, forever basically.

I had a patient that had a bicycle accident and face-planted on a pole or kerb or something like that. It affected a lot of his front teeth, and it was complex in the sense that there was no more shape of the teeth that were broken. There had to be a lot of root canal treatment done and what made it worse was that the patient had really proclined teeth -- the front teeth were sticking out more. He couldn’t really close his mouth normally. So the process of getting root canal treatment done, rebuilding the teeth. And then after I actually referred it to an orthodontist, a braces doctor who corrected that.

I think it was a bit more fun for me in the sense that we had to use the patient’s old photos to reconstruct the teeth properly, to how it looks like currently. It was a multi-disciplinary case as well. The build-ups, the bonding of the team. We had to correct the malocclusions because the teeth were very proclined.

Similar Questions

What is considered dental trauma?

Dental trauma is a very big topic and it covers quite a lot of things. The trauma that you can sustain to your teeth can be very simple or it can be very complicated. For example, you could have a small chip on your front tooth, that’s considered a traumatic injury to your tooth. It can be just a small little chip and might not even cause pain, but it can still be considered to be trauma. On the other spectrum, you could have trauma to your teeth as a result of a very serious accident, for example, road traffic accident.

Photo of Dr Gerald Tan

Answered By

Dr Gerald Tan

Dentist

Is it possible to have sustained dental trauma without knowing it?

Yes, you could have dental trauma without even knowing it. A very common minor traumatic injury to the tooth that I often see happens when you are eating. For example, if you’re eating and you are biting down on something really hard. For example, using your teeth to bite on chilli crab shells, or if you use your teeth to open beer bottles. People use their teeth to do a lot of silly things. So when you do that, sometimes you injure the tooth by using too much force on it and then you can have a chipped tooth or you can have a small crack on the tooth.

Photo of Dr Gerald Tan

Answered By

Dr Gerald Tan

Dentist

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